New Hampshire’s legislature approved changes to the state’s Medicaid program that require the development of a managed care system. This holds promise for reducing costs and even improving care, but New Hampshire’s previous experiences with managed care and those of other states suggest this may not be easy. Potential savings may be modest and take time to materialize. This Issue Brief identifies some of the pitfalls New Hampshire may face when it comes to implementing a risk-based managed care system for Medicaid patients.

House and Senate lawmakers agreed to reduce the state’s cigarette tax by 10 cents per pack and lower taxes on other tobacco products as part of the two-year budget starting July 1. Based on the latest data available from state revenue officials, this is likely to reduce tax revenue by at least $14 million to $30 million. It now appears that budget negotiators failed to account for any such revenue loss, meaning that the budget for the coming biennium will likely end up out of balance.

For the most part, the Senate followed the path laid by the House in its version of the budget, imposing substantial spending reductions across a wide array of vital public services. In broad terms, the budget supported by the Senate would lower General and Education Fund expenditures roughly $240 million or approximately 5 percent. Like the House, the Senate would cut payments for uncompensated care, reduce local aid and curtail support for higher education.

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Common Cents Blog

Investments in the operation, maintenance, and construction of transportation infrastructure in New Hampshire often draw from many different sources and funds. Decisions about financing mixes, timelines, projected interest costs, and the effects of deteriorating or enhanced transportation infrastructure at any level of government can all influence projects.